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A Technique for Serial Collection of Cerebrospinal Fluid from the Cisterna Magna in Mouse
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Standardizing a volume benchmark for cerebrospinal fluids for optimal diagnostic accuracy.

David Kim1, Susan A Alperstein2, Momin T Siddiqui3

  • 1Department of Pathology and Laboratory Medicine, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA.

Diagnostic Cytopathology
|October 12, 2020
PubMed
Summary

Higher cerebrospinal fluid (CSF) volumes improve diagnostic accuracy for malignant leptomeningeal involvement. An optimal CSF volume of 8.44 mL is recommended for malignancy cytological evaluation.

Keywords:
CSFcerebrospinal fluidflow cytometryleptomeningeal diseaseleukemialymphoma

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Area of Science:

  • Neurology
  • Oncology
  • Laboratory Medicine

Background:

  • Cerebrospinal fluid (CSF) cytomorphology is crucial for diagnosing malignant leptomeningeal disease.
  • Standardization of CSF collection volumes for optimal cytomorphologic evaluation is lacking.
  • This study aimed to determine the optimal CSF volume for diagnostic yield.

Purpose of the Study:

  • To investigate the relationship between CSF volume and diagnostic accuracy in cytomorphologic analysis.
  • To identify optimal CSF volumes for the detection of malignant leptomeningeal involvement.
  • To assess if malignancy type or flow cytometry (FC) use influences optimal CSF volume.

Main Methods:

  • Retrospective analysis of 4114 CSF samples from 2014-2018, with 2557 including flow cytometry (FC).
  • Samples categorized as unsatisfactory, negative, atypical, or positive for malignancy.
  • Statistical comparison of average CSF volumes across different diagnostic groups using t-tests and ANOVA.

Main Results:

  • Average CSF volumes were 7.48 mL (negative), 7.97 mL (atypical), and 8.44 mL (positive).
  • Positive samples from solid tumors averaged 12.0 mL, leukemia 6.73 mL, and lymphoma 8.44 mL.
  • For cases with FC, volumes varied: 10.11 mL (positive cytology only), 7.28 mL (positive cytology/FC), and 6.86 mL (negative for both).

Conclusions:

  • Increased CSF volume generally correlates with improved diagnostic results for malignancy.
  • An optimal CSF volume of 8.44 mL is suggested for cytological evaluation of malignancies.
  • Optimal CSF volumes may vary depending on the specific type of malignancy and the use of flow cytometry.